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The Contribution of Patients and Providers to the Overuse of Prescription Drugs

Author

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  • Carolina Lopez
  • Anja Sautmann
  • Simone Schaner

Abstract

Overuse of medical care is often attributed to an informed expert problem, whereby doctors induce patients to purchase unnecessary treatments. Alternatively, patients may drive overuse of medications by exerting pressure on doctors to overprescribe, undermining the doctor's gatekeeping function for prescription medications. We develop a theoretical framework and designed a randomized trial to identify the importance of patients in driving overuse of antimalarials in community health clinics in Mali. Holding doctors' financial incentives constant, we vary patients' information about the availability of a discount for standard malaria treatment. We find evidence of patient-driven demand: directly informing patients about the price reduction, instead of allowing doctors to choose whether to share this information, increases use of the discount by 35 percent and overall rates of antimalarial use by 11 percent. This increase is driven by patients least likely to have malaria, leading to a worse match between treatment and cause of illness. We find no evidence that doctors use their information advantage to sell more powerful malaria treatment or increase revenue.

Suggested Citation

  • Carolina Lopez & Anja Sautmann & Simone Schaner, 2018. "The Contribution of Patients and Providers to the Overuse of Prescription Drugs," NBER Working Papers 25284, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:25284
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    References listed on IDEAS

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    1. Anja Sautmann & Samuel Brown & Mark Dean, 2016. "Subsidies, Information, and the Timing of Children's Health Care in Mali," CESifo Working Paper Series 6057, CESifo.
    2. Michael Kremer & Jessica Leino & Edward Miguel & Alix Peterson Zwane, 2011. "Spring Cleaning: Rural Water Impacts, Valuation, and Property Rights Institutions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(1), pages 145-205.
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    6. Pascaline Dupas, 2014. "Short‐Run Subsidies and Long‐Run Adoption of New Health Products: Evidence From a Field Experiment," Econometrica, Econometric Society, vol. 82(1), pages 197-228, January.
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    8. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    9. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
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    11. Toshiaki Iizuka, 2012. "Physician Agency and Adoption of Generic Pharmaceuticals," American Economic Review, American Economic Association, vol. 102(6), pages 2826-2858, October.
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    Cited by:

    1. Böckerman, Petri & Kortelainen, Mika & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2019. "Digital Waste? Unintended Consequences of Health Information Technology," Working Papers 117, VATT Institute for Economic Research.
    2. Ziyi Wang & Lijia Wei & Lian Xue, 2024. "Overcoming Medical Overuse with AI Assistance: An Experimental Investigation," Papers 2405.10539, arXiv.org.

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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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